Part 3: Hemoglobinopathies
Katharine Batt, MD, MSc, and Thomas Reske, MD
Dr. Batt is a fellow in Hematology/Oncology, Mount Sinai Hospital New York, NY, and Dr. Reske is a fellow in Hematology/Oncology, Boston University Medical Center, Boston, MA
Question 5
An 18-year-old man with HbSb+ presents to your clinic requesting a pain medication refill. He is complaining of right hip pain that started around 3 weeks ago and has progressively worsened. He has been unable to participate in his regular activities as the discomfort has limited his mobility. His last crisis was 3 years ago and he has been able to live a regular life. He denies fever, chills, cough, and change in bowel or urinary habits. Around 3 weeks ago he fell on the hip while he was washing his car but describes the injury as rather minor. He denies other manipulation to the hip. His vital signs are blood pressure, 167/89 mm Hg; heart rate, 91 bpm; temperature, 37.2ºC; and respiratory rate, 21 breaths/min. He is in discomfort upon abduction and adduction of the right hip joint. There are no signs of cellulitis or inflammation. He ran out of his oxycodone prescription and would like a refill. What is the next diagnostic step?
